Health Affairs May 25, 2023
Yang Wang, Yuchen Wang, Angela Liu, Gerard F. Anderson, Ge Bai

The Transparency in Coverage Final Rule, implemented on July 1, 2022, required all commercial insurers offering individual and group health plans to publicly disclose their in-network negotiated rates for specific procedures and providers. This regulation is designed to use price transparency to empower payers and patients, and to further promote price competition in health care markets to contain health care spending.

One Health Affairs Forefront article suggests that the insurer price transparency data may provide an enormous and comprehensive repository of health care pricing information, with identifiable insurers, plans, procedures, and providers, for the US commercial insurance market. The data demonstrate strength compared to other existing pricing data, such as the hospital price transparency data, state all-payer claim databases, and...

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Topics: Healthcare System, Insurance, Payer, Pricing / Spending
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